25Aim/hypothesis: Placenta of women with gestational diabetes mellitus (GDM) exhibits an 26 altered lipid metabolism. The mechanism by which GDM is linked to alterations in placental lipid 27 metabolism remains obscure. We hypothesized that high-glucose levels reduce mitochondrial fatty 28 acid oxidation (FAO) and increase triglyceride accumulation in human placenta. 29 Methods:To test this hypothesis, we measured FAO, fatty acid esterification, de novo fatty 30 acid synthesis, triglyceride levels and carnitine palmitoyltransferase activities (CPT) in placental 31 explants of women with GDM or with no pregnancy complication. 32 Results:In women with GDM, FAO was reduced by ~30% without change in mitochondrial 33 content, and triglyceride content was 3-fold higher than control group. Likewise, in placental 34

Background Prediction of neonatal respiratory morbidity may be useful to plan delivery in complicated pregnancies. The limited predictive performance of the current diagnostic tests together with the risks of an invasive procedure restricts the use of fetal lung maturity assessment. Objective The objective of this study was to evaluate the performance of quantitative ultrasound texture analysis of the fetal lung (quantusFLM) to predict neonatal respiratory morbidity in preterm and early-term (<39.0 weeks) deliveries. Study Design This was a prospective multicenter study conducted in 20 centers worldwide. Fetal lung ultrasound images were obtained at 25.0-38.6 weeks of gestation within 48 hours of delivery, stored in Digital Imaging and Communication in Medicine format, and analyzed with quantusFLM. Physicians were blinded to the analysis. At delivery, perinatal outcomes and the occurrence of neonatal respiratory morbidity, defined as either respiratory distress syndrome or transient tachypnea of the newborn, were registered. The performance of the ultrasound texture analysis test to predict neonatal respiratory morbidity was evaluated. Results A total of 883 images were collected, but 17.3% were discarded because of poor image quality or exclusion criteria, leaving 730 observations for the final analysis. The prevalence of neonatal respiratory morbidity was 13.8% (101/730). The quantusFLM predicted neonatal respiratory morbidity with a sensitivity, specificity, and positive and negative predictive values of 74.3% (75/101), 88.6% (557/629), 51.0% (75/147), and 95.5% (557/583), respectively. Accuracy was 86.5% (632/730), and the positive and negative likelihood ratios were 6.5 and 0.3, respectively. Conclusion The quantusFLM predicted neonatal respiratory morbidity with an accuracy similar to that previously reported for other tests with the advantage of being a non-invasive technique.

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Any vulvar lesion with unusual characteristics or insidious evolution in labia majora or Bartholin's glands area should be carefully and promptly studied. This is particularly important in order to perform an effective surgical treatment in cases of leiomyosarcoma.

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